Nathan John Pulsipher, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2021026772 Issued in MO

Practice address

1300 N Oakland Ave Ste B
Bolivar, MO 65613-3008

Phone

(417) 326-6061

NPI assigned

Jul 2, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nathan Pulsipher DDS LLC

  dba Healthy Smiles Dental Center

  • General Practice Dentistry
  • West Plains, MO
  • NPI 1982389144
  NPD Authorized official
• Bolivar Smiles Dentistry, LLC

  • General Practice Dentistry
  • Bolivar, MO
  • NPI 1811622525
  NPD
• Sulphur Dentistry & Braces

  • Dental Clinic/Center
  • Sulphur, OK
  • NPI 1730679606
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1619594868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N OAKLAND AVE STE B",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133008",
            "telephone_number": "417-326-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N OAKLAND AVE STE B",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133008",
            "telephone_number": "417-326-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULSIPHER",
        "first_name": "NATHAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-02",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "T-7346",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2021026772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WWW.bolivarsmiles.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1300 N Oakland Ave Ste B",
            "city": "Bolivar",
            "state": "MO",
            "country_code": "US",
            "postal_code": "656133008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Presley
• Rickey Presley
• Professional Christian Counseling
• Rachel Pruett
• Shari Pruitt, LCSW
• Lynn Quennoz
• R6 Solutions LLC
• Gary L Rae, RPH
• Lakshmi Sravya Rallabandi, DMD
• Zach Reasoner

• Dentist in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.